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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 56687
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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I am just completing the Wilsons T3 protocol. My temperature

Customer Question

I am just completing the Wilson's T3 protocol. My temperature never reached 98.6 buy improved to an average of almost 98 degrees. I am still extremely weak despite the improvement. I was on 2grains of Armour thyroid before that and had experienced some improvement. After reading Dr. Starr's book Hypothroidism Type 2, I learned that some rare cases require up to 6 grains. I do think that I was born with this condition and it has gone untreated for 66 years; therefore it could take some time to recover. This summer I was too weak to read and had given up, but my husband took me to a doctor that just happened to understand that bloodtests do not show the problem if the mitochondria cells are not processing the thyroid. My gland makes the thyroid and it appears in my blood, but I have severe hypothyroidism. We are deciding what to do next...another Wilson's T3 protocol or a higher dosage of Armour. What would you suggest?
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. Thomas, MD replied 3 years ago.
Hello
Do you have a recent lab called a TSH
Have you ever had this lab?
dt
Customer: replied 3 years ago.
as I stated the problem does not show in the TSH. The doctor is treating my symptoms not the bloodtest
Expert:  Dr. Thomas, MD replied 3 years ago.
I am familiar with the theories that you are talking about.
The systems work for some people and there are subgroups that do not benefit at all.
TSH is not thyroid hormone. It secrets in response to effective metabolism of T4 into T3, so another possibility is that you are not converting to T3.
Whatever the metabolic abnormality, the TSH, in coming from the brain to stimulate the thyroid, will be high if T4 oar T3 are inadequate in any way.
I have seen numerous patients treated with this method become hyperthyroid.
6 grains would be a huge and dangerous armor dose, not matter how hypothyroid as the synthesis of that large of a dose would potentially cause life threatening problems as a starting dose no matter what or how hypothyroid you are.
This is almost 400 mg. A starting dose is 30.
2 grains is also a high dose and would be dangerous as a starting dose if one had not already been on lower doses.
TSH can be used to monitor after a dose is started.
Armour is a prescription item, by the way. Obtaining it without prescription would be illegal and not insure that you have the correct product.
It is also illegal for a doctor to manage a person's illness over the internet unless there is a therapeutic relationship, the doctor has seen the patient, etc.

So here is my recommendation.
Have your doc order a TSH.
If it is high normal [which can still reflected inadequate thryoid] start with the correct starting dose of Armour and then repeat the TSH in 6 to 8 weeks, 8 weeks preferably.
Get the TSH down to about 1.

Your temperature readings do not correlate with hypothyroidism.
In fact, body temperatures from person to person vary within a certain range regardless of thyroid function and it is only a subgroup in which this measurement means anything, and we have no way without the lab to properly identify that sub-group

Good luck
dt
Customer: replied 3 years ago.
Seems that you have not read Hypothyroidism Type 2. My doctor did ease me up to the 2 Grains of Armour and I was mildly improved. Because I have almost all the symptoms, my doctor is treating me for this. She did repeat the TSH, but I do not remember the outcome, just that she is still treating my severe symptoms. I will be speaking with her this evening and wanted a second opinion as to what to do next. I am not sure you are understanding my situation
Expert:  Dr. Thomas, MD replied 3 years ago.
I quite do
And good that you have someone monitoring this.
A TSH is a way to monitor and you should ask here what this was.
Most endocrinologists [and I highly recommend you see one, even if just for information or even to help educate the endocrinologist] would say that the range should be lowered and that TSH can go as low as .3, and certainly not as hight as the 4 or 5 high normal values on most lab reference rages. .3 to 3 has been recommended and you should find out where you are in this range, because optimal is an individual matter.
2 grains of armour is about 120 mg. My sense is that you need to be somewhere in between 20 and 120, as your doctor has indicated. I would not go up more than 15 to 30 mg on any change.
Monitoring can not be effective without the time interval in between dose changes.
Good luck again
Customer: replied 3 years ago.
Wilson's says that 99% of low basal temp people are hypothyroid despite blood test results. I did improve on the T3 protocol and certainly had no hyperthyroid tendencies. I do fall into what you would call a sub group since my bloodwork did not reflect a severe problem and yet my symptoms are severe. I had no hyperthyroid symptoms on 2 grains of Armour either...just mild improvement. I would suggest reading Hypothyroidism Type 2 by Mark Starr,MD for a different point of view.
Expert:  Dr. Thomas, MD replied 3 years ago.
Yes this is all fine and I know practitioners who use Dr. Wilson's methods.
However, the advice is still correct. Whatever dose you are on now you should not do sudden increases. If nothing, start with 30 to 60 tops. I use this preparation all of the time and rarely do more than a starting dose of 45, and don't do increments more than 30 at a time since amour contains, T4, T3, T1, etc and other active components. A steady state response is needed to make decisions regardless of who's system you are using.
Good luck again
dt
Customer: replied 3 years ago.
I could not determine from your answer if your realize that the T3 protocol goes from 7mcg to 75mcg gradually over a two week period. The patient stays at 75mcg for two weeks and then tapers down for two weeks. How is mcg different from mg? The Wilson's is different from the Armour Thyroid that was slowly increased from 30 to 129 mg. Is this conversation too difficult for the internet conversation we are having?
Expert:  Dr. Thomas, MD replied 3 years ago.
Armour is in grains
One grain is about 60mg, which is about 60000mcg.
Yes totally different as armour is dessicated pork thyroid, so not potent compared to the synthetic preparations.
dt
Customer: replied 3 years ago.
this does not compute. The highest T3 dosage was 75mcg and the highest Armour was 120mg. 75mcg would be hardly any mg.
Expert:  Dr. Thomas, MD replied 3 years ago.
Oops
100 micrograms is .1 mg. 1000 micrograms would then be 1 mg.
So 75 micrograms is .075 milligrams
The compounds are of different potencies.
So 60 mg of armour thyroid is also 6000 micrograms of armour thyroid.
The potency would not be equivalent to 60 mg of thyroid medication which would kill you.
As I said, armour is a dessicated, denatured whole gland, so the actual thryoid is in trace amounts. Completely different starting dosages and usage.
This link will have a conversion table from armour to synthroid
http://www.armourthyroid.com/con_faqs.aspx#q4
Just as an example.
dt
Customer: replied 3 years ago.
what is the T3 in the Wilsons? I thought it was desiccated. I know the Armour is ;so higher dosages are not so shocking. Again I suggest Dr. Starr;s book.
Expert:  Dr. Thomas, MD replied 3 years ago.
The T3 in the Wilson system is a compounded T3, potent, not a dissecated product.
Wilson's system recognizes that in some people it is the conversion to T3 from T4 that is the problem. Many endocrinologists now days realize this as well and test for this, using cytomel for a T3 product.
In any case T3 is a synthetic dose.

I suggest that you do not do this on your own or try to direct the care. The starting dose in the Wilson system is 7.5 micrograms, not 75 and where as Wilson liked to increase the dosage daily, others do so in 7.5 increments every two days.

Good luck again
Customer: replied 3 years ago.
you misunderstood. I did start with 7.5 mcg and built by 7.5 increments to the 75mcg. Stayed at 75 for 2 weeks with no hyperthyroid issues. What on earth gave you the idea that I did not do this under a doctoi's orders? Of xourse I have a part in directing the care. It is my body and doctors are fallible. You can not be serious! As I stated several times, I was seeking a second opinion
Expert:  Dr. Thomas, MD replied 3 years ago.
Well
the methodology is orthodox but has its rationale.
If the doc is monitoring then I don't really se a problem.
You original question was should you do the T3 protocol or a higher dose of armour thyroid.
They are two different animals.
In fact, if what you have is indeed "wilson's syndrome" as some call it, then armour thyorid would really have no rationale at all, as it would supply more T4 than T3.
In any case, the dosing is a completely different system, and 6 grains of armour to start with would most likely be a very problematic or even lethal starting dose.
If the wilson protocol works for you, it does not make theoretical sense to switch to Armour.
If you do decide with your physician that armour is the way to go [let's say the TSH is high which would not be as consistent with Wilson's] then a correct starting dose of about 1/2 grain to 3/4 grain should be used.
Good luck again

Please click ACCEPT to give answer credit. Ask more if needed. Bonuses and positive feedback most helpful. Answers for informational purposes only.

Customer: replied 3 years ago.
I did check on the TSH issue. In 2009 I was 5.21, in June 2010 5.990, in July 2010 2.120 (that was after 120mg Armour). I am now thinking that I probably need the Wilson's and the Armour. The 2,120 is so much better, but still on the high side, right?
Expert:  Dr. Thomas, MD replied 3 years ago.
2.1 is within normal. So is 5 but not really in many cases.
So yes 2.1 is a big improvement.
From there if it were my patient I would let is go for a while and repeat TSH every 8 weeks. Then make a deicions whether or not to increase the Armour slightly 15 to 30 mg, based on the clinical assessment.

Good luck again
Customer: replied 3 years ago.
I am still very weak and symptomatic. I really favor aggressive treatment because I can not function well. The wait and see approach is too conservative. I would rather push the envelope. Why do you suggest such a timid choice?
Expert:  Dr. Thomas, MD replied 3 years ago.
I am merely suggesting how armour is used. Some docs would start a large initial dose than I would, or might increment with larger step up doses, but not many. I suggest this approach because you can overshoot. Also because the effects of a dose increase are not fully seen for 6 yo 8 weeks. Thus you could overshoot by increasing too soon. Then the case gets confused.

However, your doctor will have his/her own approach to incrementation and monitoring. I do this because I am an internist and endocrinology is one of our board certification categories, so I stick to what is most safe in terms of thyroid medication. Also, the aggressive scale proposed for keeping the TSH in a new "normal" range is .3 to 3, so 2.1 would be in the true normal range. I would want to make sure this is still not going lower over 6 weeks. Clinically, there is a wide variety of response to this range, and some do well at 2, some at .8 [most in some studies], some even lower but not many.

Good luck again
Customer: replied 3 years ago.
I usually fall into the "not many" category and really feel the need for energy. I would like to be able to do my grocery shopping and dance a bit. I do not feel that is too much to ask for. 120mg of Armour did not accomplish that: so other than a higher dosage, I do not see that happening. Wouldn't the hyperthyroid issues subside by lowering the dosage if it was too high?
Expert:  Dr. Thomas, MD replied 3 years ago.
120 is not the highest dose used by any means
But it is worked up to as I explained before.
The doc treating you has to essentially estimate what starting dose you can tolerate or what increment.
If you were at 90, for example, going to 120 with a high tsh is no big deal.
I've seen 150 and even 190, but that level became hyperthyroid and yes, dissipated on readjusting the dose.
Good luck again
Customer: replied 3 years ago.
how long should one expect to see strength improvement? Can a full recovery be expected?
Expert:  Dr. Thomas, MD replied 3 years ago.
From hypothryodism length of recovery time is variable.
8 weeks to 16 weeks.
If the strength reduction is due to hypothryodism during that time period.
dt
Customer: replied 3 years ago.
once the correct dosage is achieved, right?
Expert:  Dr. Thomas, MD replied 3 years ago.
Correct
dt
Please click ACCEPT to give answer credit. Ask more if needed. Bonuses and positive feedback most helpful. Answers for informational purposes only.
Customer: replied 3 years ago.
I was not satisfied with your responses, You do not seem current and told me nothing that I did not already know.
Expert:  Dr. Thomas, MD replied 3 years ago.
I have opted out of the question.
All experts have been able to see the question and enter it,
Perhaps one will be able to help you.
I have also referred the question directly to another expert.
Good luck
dt

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